Week # 5

I had opportunity this week to meet Rebecca Tetteh.  I accompanied her to an appointment with an orthopedic surgeon in East Lagon, Ghana.   She is the girl with the crutches in the picture.  She is 10 years old.  Let me tell you about Rebecca.


Rebecca was born with bilateral dislocated hips (or hip dysplasia, I don’t know for certain which) and bilateral club feet.  To ambulate she had learned to pull herself along on all fours as a baboon would.  She would pull herself along to and from school each day, a distance of about half a mile.  She lives in Sotad village, about 50 kilometers from Accra.  


About three or four years ago a humanitarian missionary couple for the church discovered her in her village.  They arranged for her to be fit with a wheelchair through the LDS charities wheel chair program.   The care given her, however, did not stop with the wheelchair.   The humanitarian missionary couple, along with the medical advisor (same position I am now filling) started looking into other options that might be available to help her.  Over the course of a year these missionaries and the doctor arranged for her to be seen by orthopedic specialists that could surgically help her.  About two years ago she had her feet repaired and soft tissue contractures of her hips released.  When healed she was fit with shoes through the Orthopedic Training Center in Nsawam.  Crutches were made for by a volunteer here in Accra.  These pictures show her feet, before and after, and her standing for the first time, on crutches.   

 

Those that have helped Rebecca in the past continue wanting to help her.  Even though these loving people are back in the states they had arranged for Rebecca’s visit last Wednesday at an orthopedic clinic on the outskirts of Accra to be seen by one of the surgeons.  I was contacted and asked to help facilitate the visit.  Rebecca, her mother Roselin, and her brother Michael travelled by public transportation for two hours to get to the clinic in East Lagon.  I met them at the clinic.  Unfortunately, the doctor who examined Rebecca felt he had nothing further he could offer her in regards to her hips.  He suggested we see an orthopedic surgeon in the Brong Ahafo Region of Ghana who might be able to help.  This is not possible due to the difficulty of travel (about 8 hours distance from here).  We are all looking into other options, including evaluation and treatment in the states.  

I have been here five weeks now.   My frustrations with the medical system seemed to all collide with this little girl’s trip to East Lagon on Wednesday.  It took months to arrange the visit, all done through e-mails from the states.  When we checked in at 8:00 a.m. the receptionist told us we didn’t have an appointment.  When I produced copies of the e-mail correspondence she was able to miraculously find the appointment.  Even though the appointment was at 8:00 a.m. we waited approximately two hours to be seen.  The doctor did not seem very understanding of our desire to see what else could be done for this little girl.   I thought he dismissed our questions without much consideration.  I asked if his clinic would do x-ray films of her hips, pelvis, and LS spine.  He declined.  He suggested we see an orthopedic surgeon in the Brong Ahafo Region without giving any thought to the difficulty facing us in getting this girl there for evaluation.   I left the clinic quite upset.  And discouraged.  But Rebecca and her mother just smiled.  They seemed to have an abundance of the patience I was lacking.  They didn’t seem to be upset.  I drove them to the bus connection.   This little girl represents all that can be done to give compassionate, Christian, service to one in need.  One surgery has graduated her from baboon crawling to crutch walking.  Can we get another surgery, or two, to allow her to walk without crutches?  Pray for such a miracle.

I have been invited to meet again with Dr. E. D. Kitcher, head of the ENT department at Korle Bu.  I will meet with him tomorrow.  I’m hoping there might be a way to become involved with his training program. 

Last item:  two weeks ago I mentioned the upside down swivel desk chair.  This week it was the entire set of tables and bench chairs.  Only not on motorcycles.  I continue to be amazed at what these Ghanaians carry on their heads.

 

 

Week #4 -- "weatha" instead of "weather"

We’ve had a great week!  We got our satellite TV working.  We had to drive to the vendor about a mile away and pay for a month’s service, in cash, no checks or credit cards accepted.  It is Ghc $115, or about US $79, per month.  Stand in line and pay cash.  We’re going to keep it for a month and see if it is worth it.  For news we have a choice of the BBC, British CNN, British Sky News, and Al Jazeera.    We’ve been watching the news primarily on the stations from Great Britain.  When we get tired of the King’s English  -- “weatha” instead of “weather” --  we switch to Aljazeera and listen to English with an Arabic accent.   

 

In addition to leaving behind their language when they left, the British left behind a few other quirks.   We are actually not on the third floor of our apartment (as I reported last week.)  We are on the second floor.  The British call the first floor the ground floor and the second floor the first floor, etc.   All of the locks on the doors have to be turned around twice with the key to lock or unlock.   Our apartment is technically “flat 24.”  The electrical outlets are 220 volt with British plug pattern.  Each outlet has a rocker arm serving as a breaker.  We have an assortment of adaptors to fit all the different types of plugs on appliances.   The major bank is Barclay’s, a British bank.  But we drive on the right side of the road.  How did that happen?

We’ve become very bold this week, venturing out into other parts of the city.  On Thursday we walked about two miles to a grocery store and back.  On Saturday we drove to Osu, which is the “touristy” part of town.  Marsha purchased some fabric.  This is a picture of the “fabric store.”  I talked with David, a three year old, while Marsha was shopping.

 I have learned a lot about malaria this week.  We have had two missionaries very sick, VERY SICK.  One of them had a fever of 106 through the night and altered consciousness.   His fever would not come down with Tylenol and alcohol sponge bathing.  He was taken to the hospital in the morning and given IV artesunate which is curative.  He was improved within 4 hours of the medication.  The second one had been experiencing a week of headache and fever, not to 106, but above 101.  His CBC was reported as showing greater than 300 parasites per high power field.  I would have loved to see the peripheral smear.  I remember, vaguely, looking at prepared slides of malaria in medical school.  I would have found it very illuminating to be able to see this missionary’s peripheral smear firsthand.   His blood indices were also informative:  the white cell count was normal (not what I would have expected for such a fever) but the red blood cell count was a hemoglobin of 9, which is significantly anemic.  The anemia prompted me to read more about malaria.  Unbeknownst to me, a major cause of malaria death, especially in children, is the profound anemia caused by the intracellular parasites and the subsequent red blood cell hemolysis and secondary loss of oxygen carrying capacity.  When these missionaries are cured of the acute disease they are usually so wiped out they cannot function.  Now I know why.  They are anemic from the parasite hemolysis.  

We've been here an month, now.  Each day we see more of the beauty of this land and its people and less and less of what bothered us the first few days.   We love the kindness of the people.  We are beginning to see the profound photographic images all around us.  I regret not having a camera with a telephoto lens in order to shoot pictures from a distance so I would beel  feel that I am not intruding on these individuals' lives as much as I do with my little point and shoot.  I asked the woman in the first picture if I could take her picture and she was very hesitant.   After a moment she said something to me in Twi, and then turned to her side, which I assume was a consent to the picture.

 
This is a typical scene along the roadside.

3rd week

I am mindless. I should have known that the winter Olympics wouldn’t start until after Super Bowel Sunday (which, by the way, is “live” here in the morning on cable TV.)  I have to apologize for joking about the Ghanaian winter Olympic team two weeks ago. Ghana actually has a downhill skier entered in the 2010 Winter Olympics. He “learned” skiing eight years ago in Britain. Everyone watch for him. He will probably rise to instant stardom just like Eddie the Eagle did in Ski Jumping a few Olympics ago.  I’ll still hold to my bets, though, that there will be no press coverage about the Olympics here. Sports involving snow are totally foreign to these people. The only way the Olympics would be televised here would be if Snow Soccer had become a new winter Olympics venue. Can you visualize Snow Soccer? I think the Olympic Committee ought to consider it. Can you see all the players wearing soccer shorts, knee high shin guards, and snow shoes? I'm sure it would be a lot more exciting than Curling.

I’m going to describe where we live but I need to start with some of the hilarity for the week. I don’t think I’ve mentioned the motorcyclists before. If I describe the drivers as CRAZY it requires, in fairness to the drivers, that I label the motoryclists as TOTALLY INSANE. Here are some of their rules (as I have observed): don’t wear a helmet, don’t stop at red lights, drive between the lanes of cars, and if that is not feasible, drive on the sidewalks. And the best one: on two lane streets it is easier to drive toward oncoming traffic until the very last minute and then pull back into the proper lane. I’ve had this happen twice, now, and both times I knew for sure that I was going to hit the motorcyclist head on.

Here’s the funny part. On our way home this week I looked in my rear view mirror and saw an upside down swivel desk chair coming up from behind me, in the space between my lane and the adjacent lane. In an instant a motorcyclist passed me, driving full speed and balancing this desk chair on his head. I watched him until he disappeared in the distance. The motorcyclist would lean to the right and left keeping this swivel chair balanced on his head while navigating his motorcycle through the traffic. It was a visual tour de force of athleticism. (and stupidity.)  Oh, to have had a video camera.

Marsha and I live on the third floor, thirty two steps up, in one of four buildings in a gated compound called Alema Court. Our kitchen window faces the east. About every other day, or every third day, we watch through our kitchen window the boys herd the cattle through the field. Normally, this scene would be considered very pastoral, except we are in the middle of a city of 2 million people. There is no pasture anywhere. This is a city. The field is filled with rubbish and trash everywhere. The cattle eat what little grass grows among the trash.

Our west window looks across the parking lot to another building. Just outside the window is a beautiful fan palm. I have observed that the fan palm has twenty four palms and as a new one starts to unfurl its leaves in the center an old one starts dropping off the bottom, on the side opposite to the new one. A new one has been unfurling since we arrived three weeks ago and the one dropping off is just almost to the ground. What a display of symmetry in nature. We have a little balcony off the living room. I’ve taken up jump roping for exercise on the balcony. After two weeks I have decided that jump roping is even more mindless than distance running. It is hard to think of anything while jump roping except when will this stupid exercise end. I’m trying to get a treadmill for our apartment. We’ll see how long it takes to get it here. I need something for exercising other than walking the 32 steps up to the apartment door once a day and jump roping on the balcony. (It is unfortunate that bicycling to/from work is totally out of the question. If the drivers didn’t kill you the motorcyclist probably would.  Killed by a flying swivel desk chair.)

We have a small swimming pool between two of the buildings.

It needs some cosmetic work on broken concrete, missing tiles, etc., but it functions quite well. Marsha is enjoying swimming laps 2 – 3 times a week. I’m trying to join her and swim laps, but as everyone in the family knows I don’t do well in water. It doesn’t come naturally to me. It is a little more cerebrally challenging than jumping rope, however. The nicest part of the pool is the landscaping. The bougainvillea covers the entry and a lot of the fencing. It is always in overwhelming pink and purple colors, just like it looks in Hawaii. There is a little grass area at the end of the pool with a couple of chaise lounges and chairs. There are several palm trees on the periphery of the grass and a lot of interspersed colorful vegetation which I cannot name but nonetheless admire. When lying on the chaise lounges one can watch the vultures flying overhead (from a distance they look like eagles.) I assume they are looking for their next meal. What else do vultures do when circling overhead?

Our apartment has a living room with a table for eating and two bedrooms, the second one serving as “computer central.” The apartment has two bathrooms. Marsha has the east bathroom and I have the west one. Don’t think we are being spoiled; both the bathrooms combined are smaller than our one at home. Were we to have to share one we would probably have to go to counseling to prevent spouse abuse.

The kitchen is small; I’m about two feet short of touching the two walls when I stand in the center and reach for the walls. We have an electric stove/oven and a microwave. We have a small refrigerator. And we have a small washing machine as well. (No dryer; if you want to dry your clothes in a machine you have to take the clothing to the adjacent building and use the one of two dryers which works. We have learned that the clothes dry just as well on a drying rack in the second bedroom.)  Marsha is getting pretty good at using the stove/oven and microwave. She made cookies this week.

We live five kilometers from work. I’ll describe work another time.

I’ve had a couple of challenging medical issues this week. One is a missionary in Nigeria that sounds like he is approaching schizophrenia (major delusions and disordered thinking.) We’re trying to intervene before it becomes a crisis. We’ve also had a missionary who had to be hospitalized for possible meningitis. I love the Africa shotgun treatment for high fever/headache/neckache/can’t touch chin to chest complaints: IV ceftriaxone (for meningitis) and oral artemether/lumefantrine (for malaria.) No lab tests, no spinal tap. And voila, the next day the missionary is better. We’ve been to the hospital two days to see him and take him food. (Food is not provided at hospitals here; families are responsible for feeding patients. Families also have to buy the patient’s medication and give it to the nurses to give to the patients. I think that President Obama should consider this as part of his healthcare reform legislation. It would save a ton of money.)

Love to all.